The findings of this field study indicate that, for certain patients, and when used in appropriate contexts, ayahuasca can contribute to achieving abstinence from harmful drug use or to reducing drug-related harm in a significant way (i.e., consumption of less harmful substances and/or patterns of less frequent use). Ayahuasca-induced experiences can also promote deeper self-understanding, facilitate resolution of psychological issues underlying substance dependencies, and uncover positive psychological resources that the patient was unaware of, thereby increasing a sense of self-esteem and self-efficacy. All interviewed therapists referred to ayahuasca as a catalyst that can render therapeutic processes more effective and shorter, and sometimes allows for critical interventions when other strategies have failed.

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From a Western psychotherapeutic point of view, the therapeutic value of ayahuasca seems to lie primarily in stimulating the following therapeutic processes: augmenting body awareness, reducing drug-craving, triggering different types of emotional processes (catharsis, perception of previously suppressed emotions, generating inner resources for coping with emotions or urges to use), supporting introspection (self-analysis, eliciting consciousness of addiction and its adverse effects on oneself and others), and enhancing self-efficacy (becoming aware of positive aspects of oneself, thus improving self-esteem and confidence to stay sober). In the context of group treatment, ritual ayahuasca ingestion can also catalyze certain social processes that can contribute to recovery and recovery maintenance.

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Patients and therapists alike emphasized that ayahuasca can function as an ‘‘inner mirror’’ that allows one to readily accept previously denied aspects of the psyche that are usually difficult to address in therapeutic contexts. This is especially important in addiction therapy, where confronting denial mechanisms usually plays an essential role in treatment. Trying to break through denial mechanisms can be problematic, as this effort is likely to create further resistance. However, it seems that confrontation stemming from within or from a perceived spiritual source, such as ‘‘Mother Ayahuasca,’’ ‘‘Mother Earth’’ or ‘‘God,’’ can be better received, integrated, and contained by patients, as reported here:

“Ayahuasca showed me that I did not know myself…. I saw myself as through a camera or a mirror, and I was looking at myself…as if being in the presence of somebody who knows exactly who I am and how I felt, and knew what I was doing with my life” (Carlos).

Nearly all patients reported that the ayahuasca experience confronted them directly with their addiction. Some testimonies follow:

‘‘I felt the presence of a spiritual guide. This guide let me know that I did have a problem with alcoholism; before this, I was denying it. I got a strong feeling that I wanted to change’’ (Steve);

‘‘The awareness of my addiction became ever so real and the acceptance and strength as the only way to handle this aspect of myself’’ (Alonso);

The plant showed me that I was trapped in my alcoholism, that I was a slave to alcohol…. The downward path on which I was going [alcoholism] and the other path which I could choose to go was revealed to me….[I realized that] hand in hand with my alcoholism was my idleness, rage, superficialities, egoism, etc. I could say that each ayahuasca intake wastouching my insides and showing me what I was doing wrong…the way in which these things were revealed to me was fundamental, almost shocking, very precise, and so wise, that it left no room for doubting my need for change and recovery (Omar).

In addition to being directly confronted with their addiction, most patients also reported becoming aware of other dysfunctional aspects of themselves that had previously remained unconscious. Becoming aware of one’s dysfunctional patterns is a fundamental first step towards overcoming them; an idea shared by various psychological schools. Ayahuasca seems to be effective in eliciting or enhancing this process in patients undergoing substance abuse treatment, as exemplified by the following interview excerpt:

The plants…don’t just attack your addiction. In reality, the problem is not the addiction itself, the addiction is a consequence of many problems in your life… Using plants is an introspection inside yourself…. They open things inside of you…to arrive at a point where you have developed a trauma or a complex…what has blocked you and diverted your path toward alcohol or drugs (Sergio)